Ortho-Preferred

Lateral Approach to the Elbow: (Kaplan)


- See: Kocher Approach to Elbow:

- Discussion:
    - allows exposure of lateral column (for condylar frx), capitellum, and radial head,
           - it can also be used for Monteggia frx as well as for exposure for PIN decompression;
    - lateral approach is not optimal for complex low fractures of both columns (such as the transcondylar frx) of the distal end of the humerus;
    - interneural interval;
           - between EDC and ECRB, which is the same interval used in the Thompson approach to the forearm;
           - because the direct lateral approach may injure the PIN, some consider the Kocher Approach to be safer, since it affords protection to the PIN by
                     going between the aconeus and the ECU;

- Surgical Technique:
    - pt is placed in lateral or prone position;
    - make longitudinal incision proximal to lateral epicondyle which is extended distally across the radio-humeral interval;
    - the dissection is carried down between the ECRB and EDC;
           - or alternatively, dissect between EDC and ECRL;
    - this dissection will expose the supinator muscle;
           - detach the humeral and ulnar heads of the supinator to expose the annular ligament;
    - when this approach is extended distally, identify PIN as it passes through supinator muscle;
    - forearm may be kept pronated case inorder to move the radial nerve away from the plane of dissection



The lateral approach for operative release of post-traumatic contracture of the elbow.



Original Text by Clifford R. Wheeless, III, MD.

Last updated by Data Trace Staff on Wednesday, May 30, 2012 10:08 am